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The Challenge Of Obesity

Clinical Update
By Zur Institute

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Discover the Thin Within

 

The problem of obesity is spoken of as a national epidemic. Yet, there are various and conflicting theories (not all are evidence-based) of its causes and treatment. Most agree that eating and exercise are key factors in weight control.

However, behavioral studies suggest that biology and context often place eating and exercise behavior beyond a person's rational control. Environmental pressures, for instance, contribute to the increase in the prevalence of obesity. Suburban sprawl encourages people to drive more and walk less. The ubiquitous marketing and availability of delicious "high-calorie, low-nutrient" fast food can make impulse control nearly impossible.

It becomes even more difficult during the holiday season. For many, the parties, dining out, reunions and, sometimes, the loneliness and/or stress of the holidays only heighten the challenge of weight loss.

 

 
Obesity Recap:

  • Over the last 20 years, the size of average meals has increased dramatically. Very few people today have the time to do the amount of work needed to compensate for increased portion sizes.
  • At first, respected researchers found it difficult to believe their data. However, further research has led them to agree, "It is reasonable to conclude from this considerable literature that obesity is not associated with increased psychopathology."
  • Six interrelated contributors to body weight are genes, metabolism, behavior, environment, culture and socioeconomic status.
  • The most accessible areas for treatment and prevention of overweight and obesity are behavior and environment (not diet and exercise).
  • Studies of media constructions of overweight vs. eating disorders reveal a status bias. People dealing with eating disorders are presented as victims of illness while those who are overweight are considered blameworthy.
  • Studies of media presentations of anorexia and obesity in children have shown that anorexics are portrayed as victims of terrible illness beyond their parents' control. On the other hand, obesity is presented as the result of bad behavior including parental neglect.
  • Studies of mice placed on low calorie diets reveal that when finally allowed to eat ad libitum they regain the weight and more. When again placed on low calorie diets, the subsequent weight loss is slower.
  • The wages of obese and non-obese men are not significantly different, but those of obese women are significantly lower than those of non-obese women.
  • In simulated employment interviews, moderately obese individuals face bias in hiring.
  • Biological systems have evolved through ages of scarcity to hold fat and protect people from famine. However, we now live in an environment where food is often plentiful and available. As a result, neural controls of energy predispose people to obesity, and this predisposition is exaggerated by the influence of the environment, marketing of government-supported corn and cheese, and sleep patterns.
  • Outcome studies of medications (sibutramine, orlistat, topiramate and fluoxetine) have shown that the net weight loss for all drugs was less than 11 lbs. at the one year marker.
  • Surgery outcome studies present data that strongly support the superiority of surgical therapy over medical treatment in obese individuals (where obesity was defined as BMI=>40).
  • Both sides of the nature/nurture debate agree that internal and external mechanisms of behavior interact etiologically and statistically in the determination of behavior.

 

 

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